Healthcare providers' perspectives on family presence during resuscitation in the emergency departments of the Kingdom of Bahrain

Critical Care Nurses' Attitudes About Family Presence During Resuscitation: An Integrative Review

BACKGROUND

Family presence during resuscitation was introduced into clinical practice 30 years ago. Despite adoption of family-centered care by several health organizations and support for family presence during resuscitation by professional organizations such as the American Heart Association, critical care nurses' attitudes about family presence during resuscitation vary widely.

OBJECTIVE

To examine current evidence on critical care nurses' attitudes about, perceptions of, and behaviors related to practicing family presence during resuscitation.

METHODS

The method of Whittemore and Knafl guided the integrative review. Databases searched were CINAHL, PubMed, and Scopus. Articles included were English-language studies published from 2008 to 2022 that examined the perceptions of critical and emergency care nurses from adult units regarding family presence during resuscitation.

RESULTS

Twenty-two articles were included. Levels and strength of evidence were assessed with the Johns Hopkins nursing evidence-based model. The articles in this integrative review included a total sample size of 4780 health care professionals; 3808 were critical and acute care nurses.

DISCUSSION

Themes synthesized from current evidence included attitudes, benefits, barriers, demographic influence, cultural influence, and facilitators. Barriers and facilitators were associated with nursing practice in rural versus urban settings, age-related factors, years of experience, and unit-based differences in practice. Developing interventions to address identified factors can increase the practice of family presence during resuscitation in critical care settings.

CONCLUSIONS

Several factors influence the practice of family presence during resuscitation in critical care settings. Nurse leaders should consider these factors to enhance the practice of family presence during resuscitation.

Family presence during invasive procedures: a pilot study to test a tool

BACKGROUND

Family Presence During Invasive Procedures (FPDI) generates controversy among healthcare professionals. Twibell and her team designed an instrument that measured nurses' Risk-Benefit and Self-Confidence perceptions regarding family presence during resuscitation and was used in numerous studies.

OBJECTIVES

Evaluate the new tool for Family Presence Risk-Benefit and Family Presence Self-Confidence during invasive procedures and find out the opinions of the medical and nursing staff on FPDIP.

METHOD

Cross-sectional methodological pilot study. Online and paper questionnaires modified from a previous translation. A factor analysis was performed for the validity of the indices and bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards.

RESULTS

One hundred twenty healthcare professionals (22.18%) answered the survey. Cronbach's α on the Family Presence Risk-Benefit scale was 0.877. Cronbach's α on the Family Presence Self-Confidence scale was 0.937. The correlation between the Risk-Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship. A lower predisposition to Family Presence During Invasive Procedures is observed. Physicians are more reluctant than nurses.

CONCLUSIONS

The FPDI generates controversy as it alters health professionals' routines when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly physicians, do not favor FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favor of FPDI. The psychometric properties and internal consistency of the questionnaire indicate the validity and reliability of this tool.

The Effect of Family Presence During Resuscitation and Invasive Procedures on Patients and Families: An Umbrella Review

INTRODUCTION

The concept of family presence during resuscitation and invasive procedures is a controversial issue and has not been universally adopted by health care providers. Owing to the sheer number of studies in this field, we conducted this umbrella study to provide an overview of this concept with the aim of investigating the impact of family presence on patients, families, and resuscitation and invasive procedures.

METHODS

In this review, using the Joanna Briggs Institute levels of evidence umbrella methodology guidelines, the authors searched PubMed, Google Scholar, Embase, MEDLINE, Web of Science, Scopus, and the Cochrane database for systematic review and meta-analysis studies that evaluated the presence of family during resuscitation and invasive procedures without time limit until July 2020. The following key words were used for the search: family presence; family witness; parent presence; parent witness; and resuscitation.

RESULTS

A total of 254 articles published between January 1967 and July 2020 were screened. Five articles (1 meta-analysis and 4 systematic reviews) met the inclusion criteria. The review showed that family presence during resuscitation or invasive procedures does not have negative effects on family members, patients, or the resuscitation or invasive intervention process. Family members focus on the patients, not the ongoing treatment. The presence of family members is beneficial for both family members and health care staff. None of the reviewed studies reported a negative effect on family members.

DISCUSSION

The presence of parents and other immediate family members during resuscitation and invasive procedures has positive impacts on patients, families, and health care staff.